Winkler S, Köck F-X, Baier C, Springorum H-R, Beifuss A, Lechler P, Grifka J, Schaumburger J
Orthopädische Klinik für die Universität Regensburg, Asklepios Klinikum Bad Abbach, Kaiser-Karl-V.-Allee 3, 93077 Bad Abbach, Deutschland.
Orthopade. 2012 Jan;41(1):58-65. doi: 10.1007/s00132-011-1869-4.
According to current prognostic studies the numbers of revision operations of hip and knee arthroplasty will increase worldwide. As many patients undergo several revisions and become older at the same time, orthopedic surgeons will have to cope with vast bony defects during operations. The introduction of highly porous metals as surface layer or metal augments has facilitated primary stabilization of prostheses. Short and mid-term results of these new products are promising. New developments in coatings, such as cationic antimicrobial peptides represent new alternatives for antibacterial therapy of periprosthetic infections and increase osteointegration of prosthesis components. Furthermore, the new revision systems have a modular design and can be individually adapted to the patient's bony conditions during operations. In most cases this can be done without cement or in a hybrid technique.
根据目前的预后研究，全球范围内髋关节和膝关节置换术的翻修手术数量将会增加。由于许多患者需要接受多次翻修，并且年龄同时增大，骨科医生在手术过程中将不得不应对大面积的骨缺损。引入高孔隙率金属作为表面层或金属增强物有助于假体的初始稳定。这些新产品的短期和中期结果很有前景。涂层方面的新进展，如阳离子抗菌肽，为假体周围感染的抗菌治疗提供了新的选择，并增强了假体组件的骨整合。此外，新的翻修系统采用模块化设计，在手术过程中可根据患者的骨质情况进行个性化调整。在大多数情况下，这可以在无骨水泥的情况下完成，或者采用混合技术。
